Dr. Garcia-Tsao is Professor of Medicine at Yale University School of Medicine. She has dedicated her professional life to the study of complications of cirrhosis through patient-oriented research. Since having been awarded the K-24 award she has continued to significantly contribute to the knowledge of cirrhosis, a significant cause of mortality in the productive years of life. The project proposed in the initial K-24 submission was successfully completed and resulted in a publication that has led to the recommendation of using large-volume paracentesis + albumin as standard of care in the treatment of refractory ascites. As a rational followup to this study, Dr. Garcia-Tsao has now received funding to evaluate the effect of a combination of vasoconstrictors ooctreotide+midodrine) as alternative to albumin after large-volume paracentesis. Another of the goals outlined in her original K-24 submission was to focus on prophylactic therapy and on the identification of prognostic factors in chronic liver disease. In this regard, Dr. Garcia-Tsao has importantly contributed to the completion of a long trial of beta-blocker in the prevention of varices and identified portal pressure as an important predictor of cirrhosis decompensation not only in all cirrhotic patients, but particularly in those with cirrhosis secondary to hepatitis C. As program director of one of four VA Hepatitis C Resource Centers (granted during the term of the K-24 award) she will apply this knowledge to studies of antiviral therapy in the prevention of cirrhosis decompensation. As Director of the recently funded Clinical Core of the Yale Liver Center she will continue to devote major efforts toward mentoring beginning clinical investigators in POR. Mentoring of junior faculty, postgraduate fellows, medical students in POR has almost doubled since obtaining the K-24 award. Renewal of the award will allow Dr. Garcia-Tsao to maintain both POR and her mentoring endeavors to their fullest extent so she can continue to make significant contributions in the field of chronic liver disease and its complications.